Care workers in long-term care for older people: challenges of quantity and quality

Abstract

This article, drawing on a qualitative study in England, the Netherlands and Taiwan, explores how countries with very different care systems address the challenge of securing sufficient numbers of care workers with appropriate skills in ageing care. The analysis exposes the salient features of care systems, ageing-care markets and the ageing-care workforce in the three countries. To support the analysis, examples of how the countries attempt to recruit and retain ageing-care workers are provided. Key findings are that to secure an adequate number of skilled ageing-care workers, job satisfaction, coherence between care and labour policies and equal working conditions across sectors are vital. A quality ageing-care worker requires regular professional supervision and support, resources for ongoing training and career development opportunities. Most importantly, securing a sufficient number of ageing-care workers and ensuring they have appropriate skills are not isolated challenges but are interlinked and require collaboration between a range of care actors.

本文針對一項英國、荷蘭、和台灣老人長照跨國比較的質化研究，探討這三個不同照護體系的國家，如何面對確保老人長照服務員足夠的數量以及適當的技能的挑戰。對此，本研究分析針對於三個國家的老人長照體系、老人長照市場和老人長照服務員勞動力的顯著特徵。為了支持次研究分析，本文提供國家如何試圖招募和留住老人長照服務員的相關例子。本研究發現如果足夠的老人長照服務員得以確保，其工作滿意度，社會福利和勞工政策之間的連貫性，和平等的工作條件是主要的關鍵。確保優質的老人長照服務員，需要正規的專業監督和支持，持續專業進修的資源和職業發展機會。更重要的是，保證足夠數量的老人長照服務員，並確保他們有適當的技能，都不是孤立的挑戰，而是相通的因素，這需要中央和地方所有在照顧和勞工系統中的單位和人員一起合作及努力。

In dit artikel wordt op basis van een kwalitatieve studie in Engeland, Nederland en Taiwan, onderzocht hoe landen met zeer verschillende zorg systemen de uitdaging aangaan om voldoende geschoolde zorg-werknemers voor ouderen te vinden. De analyse gaat in op kenmerken van zorg systemen, de ouderen zorg, en de vergrijzing in de beroepsbevolking. Er zijn ter ondersteunen van de analyse zijn voorbeelden hoe de verschillende landen proberen, om de oudere zorg werknemers te werven en te behouden. De belangrijkste factoren om aan een hoeveelheid geschoolde oudere zorg werknemers te vol doen is: job satisfaction, samenhang tussen zorg -en werkgelegenheidsbeleid, en gelijke arbeidsvoorwaarden in alle sectoren. Professionele ouderen zorg werknemer hebben behoefte aan regelmatige professionele begeleiding, ondersteuning, training en een loopbaanontwikkeling. Een voldoende grootte groep oudere verzorgende met vaardigheden zijn met elkaar verbonden en vereisen samenwerking tussen een zorg acteurs

Keywords:

• ageing care
• care workforce
• capacity
• capability
• care regimes
• cross-national comparison

關鍵字:

• 老人照顧
• 照顧工作者
• 數量
• 能力
• 照顧制度
• 國際比較

Sleutelwoorden:

• oudere verzorging
• arbeidskracht
• capaciteit
• zorg regimes
• internationale vergelijking

Notes

1. Direct personal care, broadly means eating, feeding, cooking, showering, bathing, shopping, supervising taking medication, moving and handling. However, the level of skills to care for older people differs depending on the complexity of the health and mobility of older persons.

2. For instance, Taiwan (e.g. Wang, 2010), Australia (e.g. Howe, 2009), Austria (e.g. Österle & Bauer, 2012), Germany (e.g. Lutz & Palenga-Möllenbeck, 2010), Italy (e.g. Di Rosa et al., 2012) and Japan (e.g. Ogawa, 2012) have migrant care workers.

3. The Care Industry Programme 2002–2004 in Taiwan aimed to increase the number of direct care workers and reduce national unemployment rates by encouraging unemployed agricultural workers and women to be trained and become care workers (Council for Economic Planning and Development, 2003, 2005). Such a care worker employment policy is in some ways similar to that in France. For further information on French care worker employment policy see in Korczyk (2004).

4. The brokers in Taiwan are specific local companies registered with the government to have contact with the migrant care workers' training centre in their country of origin; to help Taiwanese to find an appropriate migrant care worker, to arrange the migrant care worker's travel to/from Taiwan and arrange their health insurance and legal documents required in Taiwan. The broker is also responsible for addressing any concern raised from the employer and migrant care workers.

5. NMDS-SC is the National Minimum Data set for Social care in England by Skills for Care. For full information visit http://www.nmds-sc-online.org.uk/Default.aspx.